The other day a few students got into a heated debate over risk factors for developing hypertension which was a question on our exam. here's the question with the choices. tell me who do you all think is more at risk. and it's very obvious which one is right.
Who's at most risk for developing hypertension?
A. a 65 yr. old 30 lb. overweight african american male.
B. a 50 yr. old woman who smokes
C. a 35 yr. old woman with a family history of hypertension
I think this question was kinda stupid. all those choices are risk factors. my instructor or whoever wrote the exam should know that HTN increases with age as well as being overweight/obese. so if someone who is 65 yrs. old and 30 lbs. overweight already, most likely has HTN.
I think you are missing the point here my dear. Number one: you are diagnosing. Are you saying that Every, AA male, that is over weight already or most likely have htn ? If so, this could not be more far from the truth. AA, overweight males are MORE at risk, but you can't ASSUME that they have it. Therefore you say they are at most at risk. The other three choices were at risk, but once again I visited that word MOST, and choice A, was Most likely of developing htn. Hope this helps. Hope this helps.
The correct answer was choice A. i chose C. my instructor said evidence shows that AA has a higher risk for HTN than other racial groups, and that was that. there is no evidence that AA has some kind of genetic defect or defective gene like there is with breast cancer, hunington's disease, that i'm aware of that would make them a higher risk. alot of HTN that occurs with AA is because of high fat/sodium diet as well as being overweight. those are risk factors that can be controlled to reduce HTN.
Your reading too much into the question...take the question at face value, weight what you are being told. Your adding too many "what ifs" into the mix. I get your reasoning, BUT its not telling you to disreguard the information that a person can control, like smoking or being overweight or diet, its just being straightforward.
While, yes, the peson who had a family history of HTN is also at risk, that is the only risk factor.
The older, AA, who is overweight has three higher risks factors AT THIS TIME...you see what I am saying?
While there is no evidence of a gentic defect in AA, they are still a higher risk group than whites.
If you want to take this one step further in the nursing realm of socioeconomic factors, (and I HATE generalizing about this), some African Americans and some other minority groups *often* lack proper education in order to learn how to avoid HTN. For example, most will have never heard of the DASH diet as a way to prevent/treat HTN. Some may have poor reading skills that impact their ability to read health literature. So these people may be at an even higher risk (generalizing here) because of their lack of education on a healthy lifestyle.
The white woman with a family history may already be very aware of which lifestyle factors affect BP for obviously more than one reason. If you want to get technical, you could reason that since she has a strong family history, she is well educated in positive health behaviours for avoiding HTN.
Your reading too much into the question...take the question at face value, weight what you are being told. Your adding too many "what ifs" into the mix. I get your reasoning, BUT its not telling you to disreguard the information that a person can control, like smoking or being overweight or diet, its just being straightforward.
While, yes, the peson who had a family history of HTN is also at risk, that is the only risk factor.
The older, AA, who is overweight has three higher risks factors AT THIS TIME...you see what I am saying?
While there is no evidence of a gentic defect in AA, they are still a higher risk group than whites.
Genetic predisposition to HTN in AA are being investigated. Genetic disposition doesn't mean defect per se, but rather mutations in SNPs. It *may* be proven correct that a subgroup of AA have a higher risk of developing HTN either independently or as a result on interaction with lifestyle factors (this is my speculation, this is not in the Abstract).
you know, this was one of those questions the day we took the exam where i was all over the place. i was back and forth with the AA male or the woman with the family history of HTN. you can read what is not there or overread a question too much. sometimes i have a tendency to do that. so i was thinking well he's 65 yrs. old and already 30 lbs. overweight so he's gotta have HTN already. so the woman doesn't have it but has a family history of HTN so she's at risk.
i'm so glad i posted this question to see what others will say. the responses really make you look at it from different ways. thanks so much.
so i was thinking well he's 65 yrs. old and already 30 lbs. overweight so he's gotta have HTN already.
Just because he might have HTN already...how does that lower his risk?
Just having the HTN doesnt' make your risk factors go away.
What if one of the answers were...a 750 lb man who hasn't left his bedroom in 20 years. High risk, but we can't rule out that he doesn't already have HTN.
you know, this was one of those questions the day we took the exam where i was all over the place. i was back and forth with the AA male or the woman with the family history of HTN. you can read what is not there or overread a question too much. sometimes i have a tendency to do that. so i was thinking well he's 65 yrs. old and already 30 lbs. overweight so he's gotta have HTN already. so the woman doesn't have it but has a family history of HTN so she's at risk.
i'm so glad i posted this question to see what others will say. the responses really make you look at it from different ways. thanks so much.
I've had test questions that I thought were kind of crazy, but when I posted it on AN many people helped me realize why a question was right and why I got it wrong. With nursing exams you must learn to never add info. or assume anything. Reading too much into questions can really throw you off. For me, thats what I had to learn. I would always sit in front of the question and say " well what if this and what if that". Good luck.
This is really crazy. That was one of our questions on a take home exam and the correct answer that our teacher gave us was C because of the family history.
This is really crazy. That was one of our questions on a take home exam and the correct answer that our teacher gave us was C because of the family history.
omg are you serious? that is so wild. a couple of us asked other teachers which one they thought and they said C and others said maybe A. you know i hate it when there are more than one right answer to a question. if she had worded it a different way like who is likely to have HTN then i would have definately picked A. i just hate this particular instructor exams she is notorious for doing this. the ati exam wasn't this crazy and i scored a proficiency level 3. the questions were not tricky and if you knew your stuff the answer was pretty obvious. btw, i would love to have take home tests. :chuckle
When I read the question the first thing that entered my mind is African American. You learn in shcool that African Americans are more at risk for developing hypertension. I think what we need to keep in mind is "what is this question asking"? It is asking " Who is at more of a risk for developing hypertension". The key component here is who is at more of a risk. Strike one, African American, strike two, Male, Strike three 30lbs overweight. Choice "A" has more risk factors for developing hypertension than the other choices.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
there is no evidence that AA has some kind of genetic defect or defective gene like there is with breast cancer, hunington's disease, that i'm aware of that would make them a higher risk.
Actually, black people tend to naturally underproduce renin, which contributes to essential hypertension. Therefore, the evidence exists that black people are genetically prone to developing HTN.
Hypertension in blacks is usually characterized by low renin, expanded volume and sensitivity to salt.
NurseLoveJoy88, ASN, RN
3,959 Posts
I think you are missing the point here my dear. Number one: you are diagnosing. Are you saying that Every, AA male, that is over weight already or most likely have htn ? If so, this could not be more far from the truth. AA, overweight males are MORE at risk, but you can't ASSUME that they have it. Therefore you say they are at most at risk. The other three choices were at risk, but once again I visited that word MOST, and choice A, was Most likely of developing htn. Hope this helps. Hope this helps.